Key result
3D model-guided biventricular repair achieves complete anatomical correction without residual shunt in an infant.
Why the study?
Left isomerism with ipsilateral hepatic venous drainage to the right- and left-sided atria is rare and presents complex cardiac anatomy for surgical planning of biventricular repair.
Case Report (n=1)
Patient-specific 3D modeling can effectively guide complex intracardiac baffling and successful biventricular repair in infants with left isomerism and anomalous hepatic venous drainage.
Answers are grounded in this paper and cite their sources.
May support 3D-guided repair planning in rare isomerism cases; leaves open generalizability and requires larger validation.
Left isomerism with ipsilateral hepatic venous drainage to the right- and left-sided atria is rare and presents complex cardiac anatomy for surgical planning of biventricular repair. This case presents a biventricular repair, guided by 3D modeling, in a patient with left isomerism, balanced complete atrioventricular septal defect (CAVSD), interrupted inferior vena cava with azygos continuation, and ipsilateral hepatic venous drainage to the right- and left-sided atria. Postnatal echocardiogram and cardiac catheterization confirmed balanced CAVSD, normal filling pressures, pulmonary overcirculation, and elevated pulmonary vascular resistance, favoring staged repair with initial pulmonary artery banding. Patient-specific 3D models allowed direct observation of the complex venous drainage into the left-sided atrium and planning of an intra-atrial baffle. At 11 months, the patient underwent biventricular repair using a 2-patch technique and intracardiac baffling. Intraoperative imaging showed no residual shunt, excellent atrioventricular valve function, and unobstructed venous drainage. This case demonstrates the value of 3D modeling in guiding biventricular repair in complex anomalous venous anatomy.
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Schroeter et al. (2026) conducted a case report in Left isomerism with balanced complete atrioventricular septal defect, interrupted inferior vena cava with azygos continuation, and ipsilateral hepatic venous drainage to the right- and left-sided atria (n=1). 3D model-guided staged biventricular repair using a 2-patch technique and intracardiac baffling following initial pulmonary artery banding was evaluated on Intraoperative surgical repair success (residual shunt, atrioventricular valve function, and venous drainage obstruction). 3D model-guided 2-patch biventricular repair and intracardiac baffling at 11 months achieved unobstructed venous drainage, excellent valve function, and no residual shunt in 1 infant.
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